National Provider Identifier Database

THERESA J RUSSELL, CADC-11 – NPI #1255465530
Specialist

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.


Contact Information

THERESA J RUSSELL, CADC-11
5494 PONY EXPRESS TRAIL
POLLOCK PINES, CA95726
Phone: 530-664-3758
Fax: 530-644-3782
Website:
Specialty Taxonomy Code
* Specialist 174400000X

* Indicates primary specialty

NPI Profile & details for THERESA J RUSSELL

NPI Number 1255465530
Credentials CADC-11
Entity Individual
Enumeration date 03/16/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor1 No
Identifiers
  • CA License #: A8463203
  • CA Other: A8463203 CADC-11
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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